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Sensitivity of a set of myocardial infarction screening criteria in patients with anatomically documented single and multiple infarcts

  • Dorina C. Sevilla
    Affiliations
    From the Department of Pathology and Medicine at Duke University Medical Center, Durham, North Carolina, USA

    From the University of Alabama Medical Center, Birmingham, Alabama, USA

    From the University of California at San Diego School of Medicine, La Jolla, California, USA

    From the Cornell University Medical College, New York, New York, USA

    From the Johns Hopkins Hospital, Baltimore, Maryland, USA

    From the University of Minnesota United Hospitals-Miller Division, St. Paul, Minnesota, USA

    From the University of West Virginia Medical Center, Morgantown, West Virginia, USA

    From the Department of Medicine at the University of Southern California, Rancho Los Amigos Campus, Downey, California, USA

    From the MILIS Study Group USA
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  • Nancy B. Wagner
    Affiliations
    From the Department of Pathology and Medicine at Duke University Medical Center, Durham, North Carolina, USA

    From the University of Alabama Medical Center, Birmingham, Alabama, USA

    From the University of California at San Diego School of Medicine, La Jolla, California, USA

    From the Cornell University Medical College, New York, New York, USA

    From the Johns Hopkins Hospital, Baltimore, Maryland, USA

    From the University of Minnesota United Hospitals-Miller Division, St. Paul, Minnesota, USA

    From the University of West Virginia Medical Center, Morgantown, West Virginia, USA

    From the Department of Medicine at the University of Southern California, Rancho Los Amigos Campus, Downey, California, USA

    From the MILIS Study Group USA
    Search for articles by this author
  • William D. Anderson
    Affiliations
    From the Department of Pathology and Medicine at Duke University Medical Center, Durham, North Carolina, USA

    From the University of Alabama Medical Center, Birmingham, Alabama, USA

    From the University of California at San Diego School of Medicine, La Jolla, California, USA

    From the Cornell University Medical College, New York, New York, USA

    From the Johns Hopkins Hospital, Baltimore, Maryland, USA

    From the University of Minnesota United Hospitals-Miller Division, St. Paul, Minnesota, USA

    From the University of West Virginia Medical Center, Morgantown, West Virginia, USA

    From the Department of Medicine at the University of Southern California, Rancho Los Amigos Campus, Downey, California, USA

    From the MILIS Study Group USA
    Search for articles by this author
  • Raymond E. Ideker
    Affiliations
    From the Department of Pathology and Medicine at Duke University Medical Center, Durham, North Carolina, USA

    From the University of Alabama Medical Center, Birmingham, Alabama, USA

    From the University of California at San Diego School of Medicine, La Jolla, California, USA

    From the Cornell University Medical College, New York, New York, USA

    From the Johns Hopkins Hospital, Baltimore, Maryland, USA

    From the University of Minnesota United Hospitals-Miller Division, St. Paul, Minnesota, USA

    From the University of West Virginia Medical Center, Morgantown, West Virginia, USA

    From the Department of Medicine at the University of Southern California, Rancho Los Amigos Campus, Downey, California, USA

    From the MILIS Study Group USA
    Search for articles by this author
  • Keith A. Reimer
    Affiliations
    From the Department of Pathology and Medicine at Duke University Medical Center, Durham, North Carolina, USA

    From the University of Alabama Medical Center, Birmingham, Alabama, USA

    From the University of California at San Diego School of Medicine, La Jolla, California, USA

    From the Cornell University Medical College, New York, New York, USA

    From the Johns Hopkins Hospital, Baltimore, Maryland, USA

    From the University of Minnesota United Hospitals-Miller Division, St. Paul, Minnesota, USA

    From the University of West Virginia Medical Center, Morgantown, West Virginia, USA

    From the Department of Medicine at the University of Southern California, Rancho Los Amigos Campus, Downey, California, USA

    From the MILIS Study Group USA
    Search for articles by this author
  • Eileen M. Mikat
    Affiliations
    From the Department of Pathology and Medicine at Duke University Medical Center, Durham, North Carolina, USA

    From the University of Alabama Medical Center, Birmingham, Alabama, USA

    From the University of California at San Diego School of Medicine, La Jolla, California, USA

    From the Cornell University Medical College, New York, New York, USA

    From the Johns Hopkins Hospital, Baltimore, Maryland, USA

    From the University of Minnesota United Hospitals-Miller Division, St. Paul, Minnesota, USA

    From the University of West Virginia Medical Center, Morgantown, West Virginia, USA

    From the Department of Medicine at the University of Southern California, Rancho Los Amigos Campus, Downey, California, USA

    From the MILIS Study Group USA
    Search for articles by this author
  • Donald B. Hackel
    Affiliations
    From the Department of Pathology and Medicine at Duke University Medical Center, Durham, North Carolina, USA

    From the University of Alabama Medical Center, Birmingham, Alabama, USA

    From the University of California at San Diego School of Medicine, La Jolla, California, USA

    From the Cornell University Medical College, New York, New York, USA

    From the Johns Hopkins Hospital, Baltimore, Maryland, USA

    From the University of Minnesota United Hospitals-Miller Division, St. Paul, Minnesota, USA

    From the University of West Virginia Medical Center, Morgantown, West Virginia, USA

    From the Department of Medicine at the University of Southern California, Rancho Los Amigos Campus, Downey, California, USA

    From the MILIS Study Group USA
    Search for articles by this author
  • Ronald H. Selvester
    Affiliations
    From the Department of Pathology and Medicine at Duke University Medical Center, Durham, North Carolina, USA

    From the University of Alabama Medical Center, Birmingham, Alabama, USA

    From the University of California at San Diego School of Medicine, La Jolla, California, USA

    From the Cornell University Medical College, New York, New York, USA

    From the Johns Hopkins Hospital, Baltimore, Maryland, USA

    From the University of Minnesota United Hospitals-Miller Division, St. Paul, Minnesota, USA

    From the University of West Virginia Medical Center, Morgantown, West Virginia, USA

    From the Department of Medicine at the University of Southern California, Rancho Los Amigos Campus, Downey, California, USA

    From the MILIS Study Group USA
    Search for articles by this author
  • Galen S. Wagner
    Correspondence
    Address for reprints: Galen S. Wagner, MD, Post Office Box 31211, Duke University Medical Center, Durham, North Carolina 27710.
    Affiliations
    From the Department of Pathology and Medicine at Duke University Medical Center, Durham, North Carolina, USA

    From the University of Alabama Medical Center, Birmingham, Alabama, USA

    From the University of California at San Diego School of Medicine, La Jolla, California, USA

    From the Cornell University Medical College, New York, New York, USA

    From the Johns Hopkins Hospital, Baltimore, Maryland, USA

    From the University of Minnesota United Hospitals-Miller Division, St. Paul, Minnesota, USA

    From the University of West Virginia Medical Center, Morgantown, West Virginia, USA

    From the Department of Medicine at the University of Southern California, Rancho Los Amigos Campus, Downey, California, USA

    From the MILIS Study Group USA
    Search for articles by this author
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      Abstract

      A subset of 3 screening criteria (Q wave ≥30 ms in lead aVF, any Q or R wave ≤10 ms and ≤0.1 mV in lead V2, and R wave >-40 ms in V1) has been proposed to identify single nonacute myocardial infarcts. Cumulatively, these 3 criteria achieved 95% specificity, and 84 and 77% sensitivities for inferior and anterior myocardial infarcts, respectively, among patients identified by coronary angiography and left ventriculography. This study establishes the true sensitivities of the set of screening criteria in 71 patients with anatomically proven single myocardial infarcts and 32 patients with multiple myocardial infarcts. In the single inferior infarct group, the aVF criterion was 90% sensitive. The V2 criterion (any Q or R wave ≤10 ms and ≤0.1 mV) was 67% sensitive in the single anterior infarct group. No single criterion proved sensitive in identifying a posterolateral infarct. The set of screening criteria performed just as well for multiple infarcts as it did for single infarcts, with a cumulative sensitivity of 72%. The overall sensitivity of the screening set in the 103 patients in all groups was 71%.
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